Bonfils P, de Preobrajenski N, Florent A, Bensimon J-L
Service d'ORL et de chirurgie cervicofaciale, faculté de médecine Paris-Descartes, université René-Descartes, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France.
Cancer Radiother. 2007 May;11(3):143-5. doi: 10.1016/j.canrad.2006.10.004. Epub 2006 Dec 4.
Choanal stenosis is usually a congenital anomaly in children. Acquired choanal stenosis after radiotherapy for nasopharyngeal carcinoma is a very rare pathology; only two publications report seven cases in the literature. We describe the clinical history, preoperative evaluation, surgical treatment and outcome of a case of acquired choanal stenosis after radiotherapy. The patient, a 56-year-old woman, presented with a history of nasopharyngeal carcinoma (T2- NO-MO) one year before that had been successful treated with radiotherapy (68 Gy). At the end of radiotherapy, she complained of complete nasal obstruction, anosmia and hearing loss due to a bilateral serous otitis media. Bilateral complete choanal stenosis was confirmed by endoscopy and CT scan. Functional endoscopic surgery was performed, and nasal stents were left in place for 3 weeks. One year after, the patient have good airflow, and a patent nasopharynx without choanal stenosis. In conclusion, choanal stenosis is an unusual complication of radiotherapy that can be successfully treated with transnasal endoscopic resection.
后鼻孔狭窄在儿童中通常是一种先天性异常。鼻咽癌放疗后获得性后鼻孔狭窄是一种非常罕见的病理情况;文献中仅有两篇报道共7例。我们描述了1例放疗后获得性后鼻孔狭窄病例的临床病史、术前评估、手术治疗及结果。该患者为一名56岁女性,1年前有鼻咽癌病史(T2-NO-MO),已成功接受放疗(68 Gy)。放疗结束时,她因双侧浆液性中耳炎出现完全性鼻塞、嗅觉丧失和听力下降。经内镜检查和CT扫描证实为双侧完全性后鼻孔狭窄。实施了功能性内镜手术,并留置鼻支架3周。1年后,患者气流良好,鼻咽通畅,无后鼻孔狭窄。总之,后鼻孔狭窄是放疗的一种不常见并发症,经鼻内镜切除可成功治疗。